Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2010 Jun;12(6):595-602.
doi: 10.1093/neuonc/noq008. Epub 2010 Feb 11.

Prolonged survival for patients with newly diagnosed, inoperable glioblastoma with 3-times daily ultrafractionated radiation therapy

Patrick Beauchesne  1 , Valerie Bernier, Charlotte Carnin, Luc Taillandier, Mohamed Djabri, Laurent Martin, Xavier Michel, Jean-Philippe Maire, Toufic Khalil, Christine Kerr, Thierry Gorlia, Roger Stupp, Remy Pedeux
Affiliations
Clinical Trial

Prolonged survival for patients with newly diagnosed, inoperable glioblastoma with 3-times daily ultrafractionated radiation therapy

Patrick Beauchesne et al. Neuro Oncol. 2010 Jun.

Abstract

Ultrafractionation of radiation therapy is a novel regimen consisting of irradiating tumors several times daily, delivering low doses (<0.75 Gy) at which hyperradiosensitivity occurs. We recently demonstrated the high efficiency of ultrafractionated radiotherapy (RT) on glioma xenografts and report here on a phase II clinical trial to determine the safety, tolerability, and efficacy of an ultrafractionation regimen in patients with newly and inoperable glioblastoma (GBM). Thirty-one patients with histologically proven, newly diagnosed, and unresectable supratentorial GBM (WHO grade IV) were enrolled. Three daily doses of 0.75 Gy were delivered at least 4 hours apart, 5 days per week over 6-7 consecutive weeks (90 fractions for a total of 67.5 Gy). Conformal irradiation included the tumor bulk with a margin of 2.5 cm. The primary end points were safety, toxicity, and tolerability, and the secondary end points were overall survival (OS) and progression-free survival (PFS). Multivariate analysis was used to compare the OS and PFS with the EORTC-NCIC trial 26981-22981/CE.3 of RT alone vs radiation therapy and temozolomide (TMZ). The ultrafractionation radiation regimen was safe and well tolerated. No acute Grade III and/or IV CNS toxicity was observed. Median PFS and OS from initial diagnosis were 5.1 and 9.5 months, respectively. When comparing with the EORTC/NCIC trial, in both PFS and OS multivariate analysis, ultrafractionation showed superiority over RT alone, but not over RT and TMZ. The ultrafractionation regimen is safe and may prolong the survival of patients with GBM. Further investigation is warranted and a trial associating ultra-fractionation and TMZ is ongoing.

PubMed Disclaimer

Figures

Fig. 1.
Fig. 1.
Flow chart of the study.
Fig. 2.
Fig. 2.
Progression-free survival for EORTC/NCIC RT vs ultrafractionation.
Fig. 3.
Fig. 3.
Overall survival for EORTC/NCIC RT vs ultrafractionation.
Fig. 4.
Fig. 4.
Progression-free survival EORTC/NCIC TMZ/RT vs ultrafractionation.
Fig. 5.
Fig. 5.
Overall survival EORTC/NCIC TMZ/RT vs ultrafractionation.
See this image and copyright information in PMC

References

    1. Behin A, Hoang-Xuan K, Carpentier AF, et al. Primary brain tumours in adults. Lancet. 2003;361:323–331. - PubMed
    1. Black PM. Brain tumor. Part 2. N Engl J Med. 1991;324:1555–1564. - PubMed
    1. Black PM. Brain tumors. Part 1. N Engl J Med. 1991;324:1471–1476. - PubMed
    1. DeAngelis LM. Brain tumors. N Engl J Med. 2001;344:114–123. - PubMed
    1. Fine HA, Dear KB, Loeffler JS, et al. Meta-analysis of radiation therapy with and without adjuvant chemotherapy for malignant gliomas in adults. Cancer. 1993;71:2585–2597. - PubMed

Publication types